Inside Dental Hygiene
February 2021
Volume 17, Issue 2

Essential Oral Healthcare During Cancer Treatment

Oral side effects are easier to prevent than to control

Jill Meyer-Lippert, RDH

Oncology and dentistry are often viewed as separate and unrelated areas of healthcare. However, as oral health has proven to impact a variety of health issues (such as cardiovascular disease, diabetes, and Alzheimer's disease), problems in one's mouth can have serious implications during cancer treatments and throughout survivorship.

Since avoiding oral health problems is far easier than repairing damage, a dental visit prior to starting cancer treatments can not only improve one's quality of life, but improve the potential for more successful treatment outcomes.

The value of dental care before starting cancer treatments includes:

Establish a baseline

Accurate oral health records can help determine immediate versus future dental needs. The baseline information will also enable the dental provider to gauge the level of changes that occur in the mouth during cancer treatments. Reviewing the effectiveness of any procedures or preventive strategies that are implemented can help determine if alterations are necessary to achieve the best results. Baseline records can also potentially aid in future coverage by insurance and other benefit programs by establishing what conditions were present or absent prior to treatments.

Treat/remove active decay and infection

Dental disease and high levels of bacterial plaque on teeth and gum tissue can accentuate side effects associated with various treatments for cancer, including chemotherapy drugs, radiation to the head and neck region, bone marrow transplants, and some targeted therapies. Removing or repairing caries, damaged teeth, and areas causing tissue irritation enhances comfort and the ability to chew effectively for proper nutrition needed to maintain weight and strength.

Many types of cancer therapies affect blood cells. When the white blood count decreases, it becomes more difficult for the body to fight infection. If infection is present inside the mouth, it can potentially spread throughout the body. Low platelet levels make the blood less likely to clot efficiently. In those cases, bleeding gums can become a serious and urgent complication. Proactive oral care will reduce the risks of mouth problems that may cause alterations or delays in treatments.

Anticipate problems and provide preventive care

Oral side effects are much easier to prevent than to control once they have started. Once the problems begin, they tend to reoccur and become more severe as the course of treatment moves forward. The patient's nurse navigator and the dental team can work together to anticipate what side effects may occur during the treatment process and develop a prevention plan. While not all medical or dental professionals have training in the specialized area known as dental oncology, online resources are available for guidance.

Patient education and modified oral hygiene instructions

It is important for patients to take an active role in their care. This requires being aware of what oral problems may occur and understanding what measures can be taken to reduce these risks. Using the proper oral care tools, techniques, and products each day can make a world of difference during this time. Make sure these recommendations are coming from a trusted source, as advertisements may be misleading or provide incomplete information. Practitioners can help patients avoid masking one issue only to cause a different problem.

Establish a follow-up plan to achieve improved quality of life into survivorship

Some oral side effects may stop as soon as treatments are complete. Others may take more time to resolve, while others, in some cases, may never subside. Catching problems early helps to reduce the complexity of the solution. Dental check-ups should also include a yearly thorough screening for oral cancers. Making a commitment to continue personal and professional oral healthcare routines throughout survivorship will provide greater protections against the physical, emotional, and financial stresses that dental disease can cause.

Dental care is an important part of systemic healthcare. Including oral health measures throughout the cancer treatment process can help provide greater patient comfort, quality of life, and treatment outcomes.

About the Author

Jill Meyer-Lippert, RDH
Founder, Side Effect Support, LLC
Manitowoc, Wisconsin

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